WO2014079807A2

WO2014079807A2 - Trocar device and use thereof

Info

Publication number: WO2014079807A2
Application number: PCT/EP2013/074063
Authority: WO
Inventors: Gerold KREUZ; Heinrich Koch
Original assignee: Trokasure Gbr
Priority date: 2012-11-20
Filing date: 2013-11-18
Publication date: 2014-05-30
Also published as: US9795409B2; EP2922483A2; EP2922483B1; JP2015534868A; US20150297260A1; WO2014079807A3

Abstract

The invention relates to a trocar sleeve or trocar and a trocar tip for minimally invasive/endoscopic surgical procedures carried out on people and animals. The trocar sleeve here has a retaining means in order to avoid the device slipping out during the operation.

Description

Trocar device and its use

The invention relates to a trocar sleeve or trocar and a trocar for minimally invasive / endoscopic surgical procedures on humans and animals.

The first laparoscopy was already in 1944 by Hans

Frangenheim and Raoul Palmer published. The pioneer of laparoscopic and pelviscopic surgery, however, is Kurt Semm, who revolutionized surgery with his spectacular interventions and inventions and established him against many hostilities starting in the mid-seventies of the last century.

In endoscopic and laparoscopic surgery, the vast majority of interventions are now performed minimally invasively. This applies to all operative areas. The term minimally invasive or keyhole surgery refers to surgical techniques over the smallest

Additions with specially developed instruments and cameras. Trocars are standard instruments in minimally invasive surgery whose use is special

Special features and risks. The trocar is an instrument that helps in the

Surgery sharp or blunt, after previous skin incision, an opening is created as access to a body cavity. In the abdominal area, this is usually inflated with preheated C02 in order to better

To create visibility. Through a trocar sleeve this is kept open. It is usually one Trocar or pin, which sits in the trocar sleeve with an inner diameter of eg 3.0 - 12mm and the tip of which closes the opening of the trocar sleeve. The trocar, for example, through the abdominal wall or the navel in the

Abdominal cavity introduced. The surgeon then has the

Remove the trocar from the trocar sleeve

Possibility with an optic (endoscope) through the

Trocar sleeve to look into the abdominal cavity or operate minimally invasive with gripping, cutting and other instruments within the abdominal cavity. (The diameter of the

Instruments are standardized so that trocars and instruments from different manufacturers fit together). This can be done by a trocar head connected to the trocar sleeve, which has a gastight port for the aforementioned instruments. Modern trocar systems are formed of either surgical steel or medical grade plastic or a combination of these materials. They are both reusable or disposable

offered. Where the trend is more and more disposable, as the treatment guidelines are always stricter and

Trocars due to the existing cavities as so-called.

Semi-critical instruments for reprocessing

get ranked. The obturator or trocar horn is adapted to the trocar sleeve and may have both a cutting and a blunt tip. In addition, there are so-called. Security trocars, in which the cutting tip is provided with a blade that moves back after penetrating the abdominal wall, to a violation of internal

To avoid organs. The trocar sleeves can have one

Valve mechanism or connection, which for

Suction, insufflation etc. is used. According to the prior art trocar sleeves are rigid and resistant to bending

pronounced to the leadership characteristics for instruments in the necessary during the operation manipulations with the To maintain instruments.

All minimally invasive procedures, primarily in the abdominal cavity and pelvic area, involve the use of trocars to provide access to the body cavity and to the pelvis

Introduction of optics and instruments in common. Trocars and their daily use have become self-evident in the field of gynecology, urology and surgery.

Trocar systems are known in a variety of designs both as reusable and as disposable systems. They usually consist of a trocar sleeve and a trocar within the trocar sleeve movable, which is often equipped at its distal end with a sharp edge for the penetration of tissue.

Pamphlets such as e.g. US 2005/0251190 or US 2007/008827 describe gas-tight access routes using

Seals and connection systems. Sealing systems are also known from US 4,943,280; US 4,655,752; US 4,978,341; EP 0 567 141 known. The latter describes a valve system that incorporates surgical

Instruments in the body of a patient in particular via a trocar system allowed. A gastight seal is guaranteed for instruments of different sizes.

More than 50% of the complications are performed intraoperatively, which means that the surgeon must act quickly to avert life-threatening situations. It is precisely during endoscopic surgery that, in these unscheduled situations, the instruments introduced via the trocar need to be changed quickly and frequently. Very often, the trocars on the market today do not have the required holding function z. B. in the

Abdominal wall and slip out with the instrument. Thereby quickly arise uncontrollable conditions because of a

(Time) consuming Neuplatzierung is needed. This

Stress factor for the entire OR team can lead to further complications. It would be desirable to have a trocar that holds securely in all situations, is atraumatic, has a favorable cost-benefit ratio and, last but not least, is simple and uncomplicated

Surgical thinking "can be appropriately placed and removed, as well as trocar systems such as the Kii

Balloon Blunt Tip System (Applied Medical), which has an inflatable balloon at the front of the trocar sleeve. After insertion of the trocar while air is blown into the balloon, causing it to expand and prevent slipping out of the trocar. A disadvantage of the system is especially the arrangement of the balloon on the outside of the trocar, whereby the balloon must be performed with through the puncture channel, resulting in the

practical application has been found to be disadvantageous. In addition, an additional connection for the air supply must be provided, which usually complicates the handling and prolongs the time for the introduction of the trocar for the surgeon. Furthermore, there is a risk that the balloon will be damaged as a result of being performed during the operation, which may result in a malfunctioning of the balloon and the risk of the trocar slipping out of the operation.

The present invention has for its object to provide an improved trocar sleeve and an improved Trokardorn for human and animal use.

This object is achieved by a trocar sheath according to claim 1, a trocar according to claim 8, a trocar heart according to claim 12 and a method according to claim 18 solved. Advantageous embodiments are specified in the dependent claims.

A first aspect of the invention relates to a trocar sleeve which is integrally formed, comprising a first and a second region, wherein the first region is formed for positioning within a body and a holding means for preventing the trocar sleeve from slipping out of the body, wherein the retaining means having web-shaped portions which are spaced from each other by openings in the trocar sleeve. In this case, the web-shaped regions have a bent initial state, so that the web-shaped regions have an inflated state. The web-shaped regions are designed such that they can transition from a bent initial state to a stretched state. In the stretched state, the web-shaped regions are formed substantially planar and the surface of the trocar sleeve has a substantially closed surface. The trocar sleeve according to the invention also has a second area, which is designed to receive a trocar.

Under a one-piece trocar sleeve is understood in the context of the invention, a trocar sleeve, which is formed from a workpiece. This can be produced for example by means of injection molding.

In one embodiment of the invention, the web-shaped regions are formed from a shape memory material or they are made so that they return to their initial state after stretching. Under

Shape memory materials and / or manufacturing techniques are understood materials and or manufacturing techniques that have or create a shape memory effect (shape memory effect) and seem to "remember" their former outer shape despite an interim strong transformation

Shape memory materials or production techniques are, for example, shape memory alloys and

Shape memory polymers and / or manufacturing techniques. In this case, the web-shaped regions are formed by the shape memory material or the shape such that they have a curved initial state and thus bring about an approximation of the first region of the trocar sleeve to the second region of the trocar sleeve. This leads to a mushrooming of the web-shaped regions in the first region, whereby a slipping out of the body is avoided.

In one embodiment of the invention, the web-shaped regions are formed from a shape-memory material, wherein the shape-memory material is a plastic. In a further embodiment of the invention, the web-shaped regions are formed in the shape of a half shell. The thus shaped half-shell-shaped areas point with the rounded side toward the inside of the trocar sleeve. Towards the outside, the web-shaped regions have a substantially flat surface, which has a curvature due to the cylindrical configuration of the trocar sleeve. In the extended state, the web-shaped regions are aligned with the first region. Due to the half-shell-shaped configuration of the web-shaped areas, these are sufficiently stable to ensure repeated stretching and diffraction. Due to the substantially flat surface is also a Risk of injury in the edge region of the puncture avoided by burrs, hinges or the like. During the extension, the half-shell-shaped inner side of the web-shaped regions preferably fits into a recess formed on the trocar dome so that the web-shaped regions and the recess are in engagement. The half shell-like configuration of the web-shaped regions thereby ensures in a simple manner the surgeon a simple and energy-saving manipulation of the trocar without losing the leadership properties for the instruments to be introduced and without causing injury to the tissues or peritoneum adjacent sites.

In one embodiment of the invention, the second is

Region formed rigid.

In a further embodiment of the invention, at least the second region, preferably the entire trocar sleeve, in the extended state has a substantially constant cross section, which is circular, oval or round.

In a further embodiment of the invention

at least the second area, preferably the whole

Trocar sleeve, a substantially constant

Cross-section, which is circular. A circular cross section offers the advantage of

Stabilization during manipulation with instruments.

In a further embodiment of the invention

at least the second area, preferably the whole

Trocar sleeve, a substantially constant

Cross-section, which is formed oval. In this case, an oval cross-section allows more room for movement for the Instruments without having to set tolerances too narrowly.

In a further embodiment of the invention, the trocar sleeve has outside markings for reading its

introduced length up. By the externally attached to the trocar sleeve markings the inserted length of the trocar sleeve can be determined, thereby avoiding possible tissue or organ injury to the patient.

In a further embodiment of the invention, the trocar sleeve has a stop device. These

Stop device serves to prevent a

independently as a result of manipulation with

Instruments caused slipping into the abdominal cavity or body cavity. In a further embodiment of the invention is the

Trocar sleeve with the exception of the web-shaped areas resistant to bending.

In a further embodiment of the invention, the trocar sleeve has an inner diameter of 3 - 15 mm. Depending on the intended use, the

Trocar case an inner diameter of 3 - 3.5, 5 - 5.5mm or 7 - 7.5mm or 10 - 10.5mm or 12 -12.5mm.

In a further embodiment of the invention, a trocar sleeve over at least an essential part of

Total length a wall thickness of 0.2 - 2mm. Depending on the intended use, the trocar sleeve has a wall thickness of 0.5-1.0 or 0.8-1.2 or 1.0mm or 1.5mm.

In a further embodiment of the invention, the trocar sleeve has a working length of 70-230 mm. In Depending on the intended use, the trocar sleeve has a total length of 70 - 80mm or 80 - 90mm or 110 - 120mm or 150 - 160mm or 160 - 170mm. The aforementioned measures are particularly suitable for use via access through the abdominal wall into the abdomen or pelvis.

In a further embodiment of the invention, the trocar sleeve in the first region has an end face which is of a conical design. In a further embodiment of the invention, the trocar sleeve has in the interior at least one means for the detachable arrangement of the trocar dart. In this case, the trocar is inserted into the trocar sleeve and arranged by means of at least one means for placement in the trocar sleeve. The means for arrangement may be formed, for example, as a means for positive connection.

For example, the positive connection can be effected by means of a latching connection of latching groove and locking lug. In this case, the trocar sleeve in the interior as a means for arranging a locking groove or latching nose have. It is also conceivable that several means for arrangement can be used for the arrangement.

Another aspect of the invention relates to a trocar comprising a trocar sleeve according to the invention and a trocar head.

In one embodiment of the invention, the trocar is made in one piece, wherein the trocar head is formed on a trocar sleeve according to the invention.

In one embodiment of the invention, the trocar is designed in two pieces. The trocar sleeve and the trocar head are liquid and gas tight with the interposition of a Seal and / or a positive connection connected together. The trocar head is usually reusable, with only the trocar as

Disposable article is made of a suitable material. In one embodiment of the invention, the trocar is designed in two pieces, the trocar sleeve and the

Trocar heads are releasably connected together.

In one embodiment of the invention, a seal is releasably disposed within the trocar head. In one embodiment of the invention, the

Trocar head at least one gas-tight valve and / or

at least one inlet and outlet for gases and / or

Liquids. The valve and / or the inlet and outlet are thereby used for insufflation of gas or the release of emerging during coagulation, obstructing the view smoke.

A further aspect of the invention relates to a trocar mandrel having a first and a second region, wherein the second region is formed tapered with respect to the first region, and wherein the first region has an end face.

The end face may taper conically or be formed blunt. At the beginning of the operation will be a

Trokardorn used, which has a conically tapered configuration, the such and in length and

Diameter adapted to the second region of the trocar sleeve is that they are in the conification of the first area of the trocar sleeve for better perforation of the abdominal wall in the

Essentially corresponds. The first area of the trocar horn is shaped to provide the surgeon with a

Insertion and insertion into the body cavity ergonomic procedure that minimizes stress and effort allows. According to the trocar dart has recesses, which for receiving the web-shaped

Regions of a trocar sleeve are formed. Preferably, the recesses are radially along the Trokardorns

arranged, wherein the number of recesses corresponds to the number of ridge-shaped regions of the trocar sleeve.

For example, 1 to 8, preferably 2 to 6, particularly preferably 2, 4 or 6 recesses are arranged along the trocar dart. Preferably, the recesses have a semicircular cross-section.

In one embodiment of the invention, the trocar is made in one piece.

In another embodiment, the trocar is

formed in two pieces, wherein the first and the second region are detachably connected. This can be the first

Area or the second area can be reused while the respective area is designed as a disposable product. As a result, increased expenses can be avoided by sterilization, if only certain parts of the trocar have to be formed, for example, of a metal or alloy.

In a further embodiment of the invention, the end face of the trocar mandrel has a conically pointed or blunt, rounded configuration. The conically tapered end face serves to puncture the

Trocar horns in the abdomen. After completion of the operation, the trocar must be removed. This rounded, blunt trocar is used to remove the trocar sleeve and prevents injury (e.g., the intestine) after the gas has been released from the abdomen.

In a further embodiment of the invention, the Trocartorn at least one means for releasably disposition of the trocar in the trocar sleeve according to the invention. In this case, the trocar is inserted into the trocar sleeve and arranged by means of at least one means for placement in the trocar sleeve. The means for arrangement may be formed, for example, as a means for positive connection. For example, the positive connection can be effected by means of a latching connection of latching groove and locking lug. In this case, the trocar may have as a means for arrangement a locking groove or latching lug. It is also conceivable that several means for

Arrangement can be used.

A further aspect of the invention relates to a kit comprising a trocar sleeve according to the invention and at least one trocar mandrel according to the invention. Advantageously, the kit comprises a trocar sleeve according to the invention as well as a trocar with a tapered conical end face and a second trocar with a blunt, rounded end face.

Another aspect of the invention relates to a system comprising a trocar according to the invention and a

at least one trocar dart according to the invention. Advantageously, the system comprises a trocar sleeve according to the invention as well as a trocar mandrel with a tapered conical end face and a second trocar mandrel with a blunt, rounded end face.

Another aspect of the invention relates to the use of a kit according to the invention for endoscopic surgery and / or diagnostics.

Another aspect of the invention relates to the use of a system according to the invention for endoscopic surgery and / or diagnostics. Another aspect of the invention relates to a method for tensioning the web-shaped regions of a trocar sleeve according to the invention comprising the steps:

Introducing a Trokardorns into a Trokarhülse, wherein the Trokardorns inside to a front side of the

Trocar sleeve strikes,

Arranging the trocar in the trocar sleeve by means of at least one detachable arrangement, wherein a means for detachable arrangement arranged in the interior of the trocar sleeve is provided with a means for releasable attachment arranged on the trocar

Arrangement engages, so that the trocar mandrel is moved in the distal direction, so that the web-shaped

Regions are transferred by the distal movement of the trocar dart from a bent initial state in an extended position, whereby the trocar sleeve a in

Has substantially closed surface,

Removing the Trokardorns from the trocar sleeve by loosening the assembly, wherein the web-shaped portions of a stretched state in a bent initial state pass.

In one embodiment of the invention, the releasable arrangement is effected by a latching of a latching groove and a latching lug.

In one embodiment of the embodiment latching of latching lug and latching groove takes place by a rotational movement of the

Trocar. Get in the rotation of the trocar

Locking nose and locking groove in engagement. The locking can be released by turning the trocar in the opposite direction again.

In one embodiment of the invention, the releasable Arrangement by a positive connection. This can be formed for example as a terminal, plug or pin connection.

The Aufpilzung the web-shaped areas in the first region of the trocar sleeve prevents complete or partial slipping out of the trocar under the operation. Due to the Aufpilzung the bearing surface, which is formed by the mushroomed web-shaped areas is increased in such a way that these on the abdominal inner wall fitting prevent slipping out safely. The in the "resting state" or "delivery state" mushroomed ridge-shaped areas are by inserting and locking or turning the

Trocar horns stretched and on the outside diameter of the

Trocar sleeve adapted. The dimensions are calculated in such a way that no overstretching and thus damage to the web-shaped areas can occur. However, it is quite conceivable that the system is already delivered in the "stretched" state, wherein the trocar mandrel is arranged inside the trocar sleeve.

When used in surgical applications thereafter, the trocar sleeve is removed from the body, the trocar mandrel being re-inserted and latched into the trocar sleeve, thereby stretching the web-shaped portions and simply removing the trocar sleeve

is guaranteed.

Due to the re-introduction and locking or twisting of the trocar an elongation of the web-shaped regions in the first region of the trocar sleeve, whereby the Aufpilzung is repealed and now a simple

Removal of the trocar sleeve is made possible. The invention also relates to a method for preparing a treatment, for the treatment or

Diagnostics in endoscopic surgery on humans or animals. Such a method comprises providing a trocar sleeve, a trocar

Obturator / trocar horns and if necessary the appropriate operation. In this case, the Trokardorn invention is in the

Introduced trocar according to the invention and possibly rotated or arranged by means of a click mechanism, resulting in an arrangement of the trocar in the trocar sleeve, whereby the mushroomed web-shaped areas are stretched. Thereafter, the puncture of the trocar in

Operating area. Subsequently, the trocar is removed from the trocar sleeve, whereby the extension of the web-shaped areas is canceled and these now fungus inside the body. After surgery, the trocar is reintroduced and the web-shaped areas stretched again. Thereafter, the trocar can be completely removed without much effort. The present invention enables a secure,

sterile access to the abdominal area. Furthermore, it prevents the unwanted slipping out of the trocar or the trocar due to insufficient independent holding function in the abdominal wall, as could be determined by comparative experiments. It turned out that the im

Trocar head introduced seal (s), which are to ensure the quite desired gas tightness, the

introduced instruments a frictional resistance

oppose, which provides for a so-called entrainment effect, and the trocar sleeve retracts completely or partially into the abdominal wall or pulls it out completely. Another

Advantage of the present invention is to provide a surgical instrument and method, which after completion of the Intervention allows a secure closure of the inlet opening.

The puncture preferably takes place through the abdominal wall until the distal end of the trocar or the trocar sleeve remaining after retraction of the trocar mandrule protrudes slightly beyond the peritoneum into the abdomen, wherein the holding means, which is embodied for example as a specially shaped mushroom, on the one hand prevent slipping or slipping back . one

Slipping out within the puncture channel or from the

Stitch channel prevented. The special Aufpilzung is

dimensionally stable, which means that after opening the Aufpilzung a dimensionally stable state is achieved. Formfest also means that the trocar sleeve when used as intended in

Essentially its shape and leadership features for

Maintains instruments etc. For this purpose, the holding means may be formed, for example, from a shape memory material.

Preferred embodiments of the invention will become apparent from the combinations of the claims or individual features thereof.

The invention is based on some

Embodiments and associated figures will be explained in more detail. The embodiments are intended to describe the invention without limiting it. It show in

1 is a schematic cross-sectional view of a trocar sleeve according to the invention with a mushrooming of the web-shaped elements in the first region of the trocar sleeve, in FIG

Fig. 2 is a schematic representation of a trocar sleeve according to the invention with an inserted invention Trocar obturator of a mushrooming of the web-shaped elements in the first area of the trocar sleeve, in

Fig. 3 is a schematic cross-sectional view of a trocar sleeve according to the invention with an inserted

Trocarutorn invention a Aufpilzung the

web-shaped elements in the first region of the trocar sleeve, in

Fig. 4 is a further schematic representation of a

Trocar sleeve according to the invention with inserted

Trocar dart according to the invention and stretched web-shaped areas, in

5 shows a schematic representation of a trocar sleeve according to the invention with inserted trocar mandrel according to the invention and FIG

Fig. 6 is a schematic representation of a Trokardorns invention.

In a first embodiment, in Fig. 1

schematically illustrated a trocar sleeve according to the invention. The trocar sleeve 1 has a first and a second region 3,4. The first region 3 has at its end an end face which is conical. In the first region 3, the trocar sleeve has a holding means 5, which, for example, as web-shaped regions. 6

is formed on, this web-shaped area can be about a shape memory material, such as a shape memory plastic or special

Manufacturing techniques may be formed and, for example, have a half-shell-shaped configuration in the direction of the interior of the trocar sleeve 1. Here are the web-shaped

Areas 6 in the initial state in a curved position, so that a mushrooming of the web-shaped regions. 6

is trained. The trocar sleeve 1 also has in FIG. 1 a trocar head 12, which comprises, for example, a gas-tight valve 13 and at least one latching lug 15.

FIG. 2 shows a trocar sleeve 1 according to the invention with an inserted trocar mandrel 2 according to the invention

shown. It can be seen that the web-shaped regions 6 in a curved position, ie still in

Initial state are.

Inside the trocar sleeve 1 is a trocar 2

arranged, which also has a first and a second region 8,9. The first region 8 is tapered tapering and has a tip 10 which is formed for piercing.

FIG. 3 shows a schematic cross-sectional view of FIG. 2. In this case, the trocar grain 2 is clearly visible in the interior of the trocar sleeve 1. In addition, FIG. 3 shows that the latching lug 15, which is arranged on the trocar head 12, is in engagement with a latching groove 16, which is arranged in the interior of the trocar mandrel handle 14. By latching, for example by means of rotational movement of Trokardorngriffs 14, the locking lug 15 is engaged in the locking groove 16, wherein the trocar 2 in the direction of the first region 3 of

Trocar sleeve 1 is moved. As a result, there is an extension of the web-shaped regions 6, as shown in Fig. 4. As a result of the half-shell-shaped configuration of the web-shaped regions 6, these can be arranged, when stretched, in recesses 11 of the trocar mandrel 2, so that a substantially uniform surface is formed. This is particularly important against the background of minimizing edge injuries. By the locking of

Locking lug 15 and locking groove 16 is a constant

Extension of the web-shaped regions 6 ensured. When stretched, the trocar is in the operating area pierced and then solved the locking of locking lug 15 and locking groove 16 by turning in the opposite direction, so that the trocar 2 can be pulled out of the trocar sleeve 1. By releasing the locking latching lug 15 and locking groove 16, the extension of the web-shaped regions 6 is released. Due to the

Embodiment of the web-shaped regions 6 of a

Shape memory material, these now return to their initial state, which leads to a Aufpilzung. Through this Aufpilzung, which takes place in the lumen, is a

Slipping out of the trocar sleeve 1 prevented.

To remove the trocar after completion of the operation, the trocar 2 is optionally inserted with rounded or blunt pointed into the trocar sleeve 1 and turn by Trokardorngriff 14 in turn a locking detent 15 and detent 16 causes. This will again be a

Extension of the web-shaped regions 6, whereby the

Aufpilzung is repealed and the trocar sleeve 1 can now be removed. FIG. 5 again shows a schematic representation of a trocar sleeve 1 with inserted trocar mandrel 2, wherein the web-shaped regions 6 are clearly visible in the initial state and are therefore mushy.

FIG. 6 shows a trocar grain 2 according to the invention

which has a first and a second region 8, 9. The Trokardornspitze 10 is conically tapered to a simple piercing in

To ensure operating range. In addition, the

Trocar 2 according to the invention recesses 11, which are arranged along the longitudinal axis of the trocar 2. These recesses 11 are designed to receive the inside of the web-shaped regions 6, so a substantially closed surface of the trocar sleeve 1 is formed.

In another not shown

Embodiment, the arrangement of the trocar 2 in the trocar sleeve 1 by means of a clamping connection.

Using the example of an intervention, the field of application of the new invention is explained. The intra-abdominal lumen is easily accessible via the navel using a special vernier needle and bloating the abdomen with prewarmed CO ₂ and a special trocar such as a camera trocar. The trocar sleeves or trocars according to the invention, so-called working trocars, are then placed under view. This can be 1-4 pieces, depending on the operation and design, but usually 2 pieces. These can be used to introduce the actual surgical instrument (s). After completion of the intra-abdominal procedure, the instrument (s) are removed and, if necessary, cutaneous wound closure is performed.

LIST OF REFERENCE NUMBERS

1 trocar sleeve

2 trocar horn

3 first region of the trocar sleeve

4 second area of the trocar sleeve

5 holding means

6 bar-shaped area

7 front side of the first region of the trocar sleeve

8 tapered first portion of the trocar 9 second portion of the trocar

10 tip of the trocar horn

11 recesses

12 trocar head

13 gas-tight valve

14 Trocargrass handle

15 latch

16 locking groove

Claims

Claims Trokarhülse (1), which is integrally formed, comprising a first and a second region (3,4), wherein

- The first region (3) for positioning within a body and a holding means (5) for avoiding slipping out of the trocar sleeve (1) from the body, wherein the holding means (5) web-shaped regions (6), which through openings (11) in the trocar sleeve (1) are spaced from each other, wherein the web-shaped regions (6) have a bent initial state, whereby the web-shaped regions (6) have an inflated state and

- The second region (4) which is adapted to receive a Trokardorns (2).

2. Trocar according to claim 1, characterized in that the web-shaped regions (6) are formed from a shape memory material.

3. Trocar sleeve according to one of claims 1 or 2, characterized in that the web-shaped regions (6) are formed in a half-shell-shaped.

4. Trocar sleeve according to one of the preceding claims, characterized in that the trocar sleeve (1) has outside markings for reading its inserted length.

5. Trocar sleeve according to one of the preceding claims, characterized in that the trocar sleeve (1) has a stop device.

6. trocar sleeve according to one of the preceding claims, characterized in that the trocar sleeve (1) has an inner diameter of 3 - 15 mm, over an at least substantial part of the total length of a wall thickness of about 0.2 - 2mm and a total length of 70 - 230mm having.

7. Trocar sleeve according to one of the preceding claims, characterized in that the trocar sleeve (1) a

Latch (15) for arranging the Trokardorns (2).

8. trocar comprising a trocar sleeve (1) according to any one of claims 1 to 8 and a trocar head (12).

9. Trocar according to claim 9, characterized in that the trocar is made in one piece.

10. Trocar according to claim 9, characterized in that the trocar is designed in two pieces, wherein the trocar sleeve (1) and the trocar head (12) are detachably connected to each other.

11. Trocar according to one of claims 9 to 10, characterized in that the trocar head (12) comprises at least one gas-tight valve and / or at least one inlet or outlet for gases and / or liquids.

12 trocar dome (2) having a first and a second region (8,9), wherein the first region (8) has an end face (10), wherein the trocar dart (2) recesses (11), which for receiving the web-shaped regions (6) of a trocar sleeve (1) are formed.

13. trocar dart according to claim 12, characterized in that the trocar dart (2) is formed in one piece or in two pieces.

14. trocar dart according to any one of claims 12 or 13, characterized in that the trocar has a detent groove (16) which is designed for engagement in a latching lug (15) of a trocar sleeve (1).

15. trocar dart according to one of claims 12 to 14, characterized in that the trocar tip (10) is conically tapered or rounded.

16. Kit comprising a trocar sleeve (1) according to one of claims 1 to 7 and at least one trocar dart (2) according to one of claims 12 to 15.

17. System comprise a trocar according to one of claims 8 to 11 and at least one trocar (2) according to one of claims 12 to 15.

18. Use of a kit according to claim 16 and / or a system according to claim 17 for endoscopic surgery and / or diagnostics.

19. A method for tensioning web-shaped regions (6) of a trocar sleeve (1) according to one of claims 1 to 7, comprising the steps: Introducing a trocar (2) into a trocar sleeve (1), wherein the end face of the trocar (10) strikes inside an end face of the trocar sleeve (5),

Arranging the trocar dart (2) in the trocar sleeve (1) by at least one detachable arrangement, wherein a means for detachable arrangement (15) arranged in the interior of the trocar sleeve (1) is provided with a means for detachable arrangement (16) arranged on the trocar dart (2). is engaged, so that the trocar (2) is moved in the distal direction, so that the web-shaped regions (6) are transferred by the distal movement of the trocar dart (2) from a bent initial state to an extended position, whereby the trocar sleeve (1) having a substantially closed surface,

Removing the trocar (2) from the trocar sleeve (1) by loosening the arrangement, wherein the web-shaped regions (6) of a stretched state in a bent initial state pass.

20. The method according to claim 19, characterized

characterized in that the detachable arrangement is effected by a positive connection.

21. The method according to any one of claims 19 or 20,

characterized in that the detachable arrangement is effected by latching of Trokardorn (2) and trocar sleeve (1) by a latching mechanism.

22. The method according to claim 21, characterized

characterized in that the latching of locking groove (15) and latching lug (16) by turning the trocar dart (2) in the trocar sleeve (1).